NICU空气环境消毒对患者医院感染及病原菌谱的影响

Effect of air disinfection in NICU on nosocomial infections and pathogens spectrum

目的研究神经内科重症监护病房（NICU）持续改良病房空气消毒方案对医院感染感染及病原菌谱影响,分析医院感染的危险因素。方法自2010年5月-2012年12月于某医院NICU连续制定多个空气环境消毒方案,将其中收治3~6例患者的大NICU单元作为A组,收治1~2例患者的小NICU单元作为B组,调查医院感染的危险因素,数据采用SPSS 17.0软件进行统计分析。结果 592例患者中发生医院感染146例、184例次,医院感染率24.66%、例次感染率31.08%;医院感染部位主要为下呼吸道,占75.69%;146例医院感染患者中有129例送检了病原学检查,送检率88.36%;病房空气环境及患者被服的细菌数超标、侵入性操作是NICU医院感染危险因素（P〈0.05）。结论加强NICU空气消毒是预防控制革兰阳性菌菌和真菌性医院感染的重要手段,制定优良的病房空气消毒方案和规范使用抗菌药物,是预防控制NICU医院感染和避免产生耐药性的重要措施。

OBJECTIVE To investigate the effects of the modified air disinfection program in NICU on nosocomial infections and pathogens spectrum so as to analyze the risk factors for nosocomial infections. METHODS Different air disinfection methods according to the monitoring result of NICU air environment in a 3A grade hospital were set up from May 2010 to Dec. 2012. Patients who were admitted in the big unit of NICU where accommodated 3 to 6 eases were chosen as group A and those admitted in the small unit accommodated 1 to 2 cases were selected as group B. The nosocomial infection related risk factors were investigated. SPSS 17.0 was adopted for statistical a- nalysis. RESULTS Among the 592 cases of patients, 146 cases and 184 case times appeared hospital infection and the hospital infection rate was 24. 66%and cases time infection rate was 31.08%. Low respiratory tract was the main infected sites in hospital infections, accounting for 75.69%. Among the 146 cases, 129 cases received etio- logical examination and the inspection rate was 88.36 %. Exceeded bacterial number of NICU air environment and linen of the patients and invasive procedure were risk factors for nosocomial infections （P〈0.05）. CONCLUSION Strengthening the NICU air disinfection of the environment is an important means to prevent and control the gram- positive bacteria and fungi and setting up high quality air disinfection plans and standards for normally use of anti- biotics are important measures of preventing and controlling nosocimial infections in NICU and avoiding drug re- sistance.